Optical penetrating adapter for surgical portal

ABSTRACT

An optical penetrating adapter for mounting to a surgical portal to permit visualization through the surgical portal includes an adapter member defining a longitudinal axis and having a transparent window adapted to penetrate tissue and to permit visualization therethrough and means for coupling the adapter member to the surgical portal. The transparent window may have various shapes and configurations adapted to penetrate, dissect, resect or separate tissue in a non traumatic manner. Alternatively, the transparent window may incorporate structure such as cutting edges blades, points, etc to pierce, cut or incise tissue.

BACKGROUND

1. Technical Field

The present disclosure relates to an apparatus for penetrating bodytissue during minimally invasive surgical procedures, such as endoscopicor laparoscopic procedures. More particularly, the present disclosurerelates to an optical penetrating adapter for mounting to an endoscopicportal for providing penetrating capabilities to the portal while alsopermitting visual observation during penetration of the peritoneum orother body tissue.

2. Background of the Related Art

Minimally invasive surgical procedures, including endoscopic andlaparoscopic procedures, permit surgery to be performed on organs,tissue and vessels far removed from an opening within the tissue.Laparoscopic procedures are performed in the interior of the abdomenthrough a small incision such as, for example, a narrow endoscopic tubeor cannula inserted through a small entrance incision in the skin.Typically, after the abdominal cavity is insufflated, a trocar is usedto puncture the cavity wall, i.e., the peritoneal lining, to create apathway to the underlying surgical site. Generally, the trocar includesa stylet or obturator having a sharp tip for penetrating the bodycavity, which is positioned coaxially within an outer cannula. Thestylet is removed, leaving the outer cannula in place for reception ofinstrumentation utilized to perform the surgical procedure. An exampleof a known trocar is described in commonly assigned U.S. Pat. No.6,319,266 to Stellon, which issued Nov. 21, 2001, the contents of whichare incorporated herein in its entirety by reference. However, withknown trocars, advancement of the stylet through tissue is typicallyperformed blind, i.e., without visualization of the tissue beingentered.

SUMMARY

Accordingly, the present disclosure is directed to further improvementsin accessing tissue during endoscopic or laparoscopic surgicalprocedures. In particular, the present disclosure provides a transparentpenetrating adapter adaptable to a conventional endoscopic portal topermit direct visualization of body tissue during penetration of thebody cavity. Moreover, the transparent penetrating adapter may bemounted to a conventional cannula to provide penetrating capabilities tothe cannula while providing an optical window for a viewing devicepositioned in the cannula during entry into the body cavity.

Generally, the present disclosure is directed to a method for theabdominal cavity, including the steps of providing a penetrating endmember adapted to pass through tissue, mounting the penetrating endmember to a surgical portal and advancing the penetrating end memberthrough the abdominal wall to permit the surgical portal to access anunderlying surgical site.

The present disclosure is also directed to a method for providingvisualized entry into the abdominal cavity, including the steps ofproviding an optical penetrating adapter, coupling the opticalpenetrating adapter to a surgical portal, positioning a viewing devicewithin the surgical portal and advancing the surgical portal through theabdominal wall while viewing with the viewing device the underlyingtissue through the optical penetrating adapter.

In an alternate embodiment, the present disclosure is directed to anoptical penetrating system including a surgical portal having at leastone seal for maintaining insufflation pressure in the abdominal cavity,an adapter member defining a longitudinal axis and having a transparentwindow adapted to penetrate tissue and to permit visualizationtherethrough, and means for coupling the adapter member to the surgicalportal. The transparent window may have various shapes andconfigurations adapted to penetrate, dissect, resect or separate tissuein a non traumatic manner. Alternatively, the transparent window mayincorporate structure such as cutting edges blades, points, etc topierce, cut or incise tissue.

A kit incorporating at least one or a plurality of different opticalpenetrating adapters with or without a cannula and/or endoscope is alsocontemplated.

BRIEF DESCRIPTION OF THE DRAWINGS

Preferred embodiments of the present disclosure are describedhereinbelow with references to the drawings, wherein:

FIG. 1 is a perspective view of the optical penetrating adapter inaccordance with the principles of the present disclosure and shown in adisassembled condition relative to a cannula assembly;

FIG. 2A is a side plan view of the optical penetrating adapter mountedabout the cannula sleeve of the cannula assembly in accordance with theembodiment of FIG. 1;

FIG. 2B is a side plan view of the optical penetrating adapter mountedwithin the cannula sleeve of the cannula assembly in accordance with analternate embodiment of the present disclosure;

FIG. 2C is a top plan view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 1-2A;

FIG. 2D is a top plan view of an alternate embodiment of the opticalpenetrating adapter of FIGS. 1-2A;

FIG. 2E is a side plan view of the optical penetrating adapter inaccordance with the embodiment of FIG. 2D;

FIG. 3A is a top plan view of an alternate embodiment of the opticalpenetrating adapter of the present disclosure;

FIG. 3B is an axial view of the optical penetrating adapter inaccordance with the embodiment of FIG. 3A;

FIG. 3C is a side plan view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 3A-3B;

FIG. 3D is a cross-sectional view taken along the lines 3D-3D of FIG. 3Cillustrating the concave surfaces of the optical penetrating adapter inaccordance with the embodiment of FIGS. 3A-3C;

FIG. 3E is a cross-sectional view similar to the view of FIG. 3Dillustrating an alternate embodiment of the optical penetrating adapterhaving planar surfaces;

FIG. 4A is a side plan view of another alternate embodiment of theoptical penetrating adapter of the present disclosure;

FIG. 4B is an axial view of the optical penetrating adapter inaccordance with the embodiment of FIG. 4A;

FIG. 4C is a top plan view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 4A-4B;

FIG. 5A is a top plan view of another alternate embodiment of theoptical penetrating adapter of the present disclosure;

FIG. 5B is a bottom plan view of the optical penetrating adapter inaccordance with the embodiment of FIG. 5A;

FIG. 5C is a side plan view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 5A-5B;

FIG. 5D is a perspective view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 5A-5C;

FIG. 5E is an axial view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 5A-5D;

FIG. 6A is a top plan view of another alternate embodiment of theoptical penetrating adapter of the present disclosure;

FIG. 6B is a bottom plan view of the optical penetrating adapter inaccordance with the embodiment of FIG. 6A;

FIG. 6C is a side plan view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 6A-6B;

FIG. 6D is a perspective view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 6A-6C;

FIG. 6E is an axial view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 6A-6D;

FIG. 7A is a top plan view of another alternate embodiment of theoptical penetrating adapter of the present disclosure;

FIG. 7B is a bottom plan view of the optical penetrating adapter inaccordance with the embodiment of FIG. 7A;

FIG. 7C is a side plan view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 7A-7B;

FIG. 7D is a perspective view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 7A-7C; and

FIG. 7E is an axial view of the optical penetrating adapter inaccordance with the embodiment of FIGS. 7A-7D; and

FIG. 8 is a view illustrating the optical penetrating adapter mounted tothe cannula assembly and with an endoscope positioned therein to permitvisualization during penetration of tissue.

DETAIL DESCRIPTION OF PREFERRED EMBODIMENTS

Referring now to the drawings, in which like reference numerals identifyidentical or substantially similar parts throughout the several views,FIG. 1 illustrates the optical penetrating adapter 100 of the presentdisclosure with an access device or portal such as cannula or trocarassembly 200. Cannula assembly 200 may be any conventional cannulasuitable for the intended purpose of accessing a body cavity andtypically defines a passageway permitting introduction of instrumentstherethrough. Cannula assembly 200 is particularly adapted for use inlaparoscopic surgery where the peritoneal cavity is insufflated with asuitable gas, e.g., CO₂, to raise the cavity wall from the internalorgans therein. Cannula assembly 200 is typically used with an obturatorassembly (not shown) which may be blunt, a non-bladed, or a sharppointed instrument positionable within the passageway of the cannulaassembly 200. In a conventional procedure, the obturator assembly isutilized to penetrate the abdominal wall or introduce the cannulaassembly 200 through the abdominal wall, and then subsequently isremoved from the cannula assembly to permit introduction of the surgicalinstrumentation utilized to perform the procedure through thepassageway.

Cannula assembly 200 includes cannula sleeve 202 and cannula housing 204mounted to an end of the sleeve 202. Cannula sleeve 202 defines alongitudinal axis “a” extending along the length of the sleeve 202.Sleeve 202 further defines an internal longitudinal passage 206dimensioned to permit passage of surgical instrumentation. Sleeve 202may be formed of stainless steel or other rigid materials such as apolymeric material or the like. Sleeve 202 may be clear or opaque. Thediameter of sleeve 202 may vary, but typically ranges from about 4.5 toabout 15 mm for use with the seal assembly 100 of the presentdisclosure.

Cannula housing 204 may include several components connected to eachother through conventional means or alternatively may be a singlehousing component. Cannula housing 204 further includes diametricallyopposed housing grips 208 dimensioned and arranged for grippingengagement by the fingers of the user. Such grips may include aperturesfor suture-anchoring the cannula assembly 200 to the body. Cannulahousing 204 may be attached to cannula sleeve 202 by any suitable meansor may be integrally formed with cannula sleeve 202. Cannula housing 204may further include an internal zero closure valve which is adapted toclose in the absence of a surgical instrument and/or in response to thepressurized environment of the insufflation gases present in theabdominal cavity. One suitable zero closure valve contemplated for usewith cannula housing 204 is a duck bill valve, flapper valve, or thelike.

Cannula housing 204 may also include seal assembly 210 which ispreferably releasably connected to the proximal end of cannula housing204. Seal assembly 210 includes seal housing 212 and an internal seal(not shown) disposed within seal housing. The internal seal ispreferably adapted to form a substantial fluid tight seal about aninstrument inserted through the seal. One suitable internal seal is aflat disc-shaped valve, balloon valve, etc. . . . The internal seal maycomprise a flat disc-shaped, conical, or hourglass-shaped memberincluding a fabric material molded with an elastomer. The sealsdisclosed in certain embodiments of commonly assigned U.S. Pat. No.6,482,181, the entire disclosure of which is hereby incorporated byreference, may be used. Seals disclosed in certain embodiments ofcommonly assigned U.S. Patent Application No. 2004/0066008A1, filed Oct.4, 2002 the entire disclosure of which is hereby incorporated byreference herein, may be used. In a further alternative, the internalseal is preferably a fabric seal and is desirably arranged so as to havea constriction. For example, the valve may have the general shape of anhourglass. The fabric can be a woven material, a braided material, or aknitted material. The type of material is selected to provide a desiredexpansiveness. For example, a braid of varying end count and angle maybe selected. A preferred material is a synthetic material such as nylon,Kevlar (Trademark of E.I. DuPont de Nemours and Company) or any othermaterial that will expand and compress about an instrument insertedtherethrough. The selected material desirably minimizes or prevents theformation of gaps when the instrument is introduced into the seal. Thematerial of the seal may be porous or impermeable to the insufflationgas. If porous, the seal may include a coating of a material which isimpermeable to the insufflation gas or at least a portion of the valvemay be coated. In addition, the fabric may be coated on its interiorwith urethane, silicon or other flexible lubricious materials tofacilitate passage of an instrument through the seal. In certainembodiments, the fabric is twisted about the axis “a” so as to form aconstriction or closed portion. The fabric is desirably constructed of amaterial and/or arranged so that the fabric forms a constriction orclosure. The seal may also be molded so as to have a constriction or maybe knitted, braided or woven so as to have a constriction. Otherarrangements for the seal are also envisioned.

Referring now to FIG. 1 and FIG. 2A, optical penetrating adapter 100 ofthe present disclosure will be discussed. Optical penetrating adapter100 is contemplated for mounting to cannula sleeve 202 to providecannula assembly 200 with penetrating capabilities thus obviating theneed for a separate obturator introduced within the cannula sleeve 202.Optical penetrating adapter 100 when mounted to cannula assembly 200 isparticularly suitable for use with a viewing device such as an endoscopeor laparoscope introduced within cannula sleeve 202. In this capacity,optical penetrating adapter 100 serves as a window for the endoscope topermit direct visualization of body tissue during penetration of theperitoneal cavity or other tissue portions. Optical penetrating adapter100 is dimensioned to pass through body tissue and may incorporatestructure to separate, retract, dissect, cut, puncture, or pierce thebody tissue. Such structure is inclusive of cutting edges, blades,points, etc.

Optical penetrating adapter 100 includes proximal mounting section 102and distal penetrating section 104, and defines adapter axis “x”.Proximal mounting section 102 is generally cylindrical in configurationdefining internal bore 106 which receives the distal end of cannulasleeve 202. In a preferred embodiment, mounting section 102 isdimensioned to engage cannula sleeve 202 and form a frictionalrelationship therewith so as to mount optical penetrating adapter 100 tocannula assembly 200 as shown in FIG. 2A. Alternatively, as depicted inFIG. 2B, proximal mounting section 102 may be dimensioned to becoaxially positioned within longitudinal passage 206 of cannula sleeve202 and secured within the cannula sleeve 202 through a frictionalrelationship or the like. Other means for mounting optical penetratingadapter 100 to cannula sleeve 202 are also envisioned including abayonet coupling, snap fit, tongue and groove mechanism, etc. Theproximal mounting section 102 and cannula sleeve 202 are desirablyarranged so that the outer surface of the optical penetrating adapter100 is flush with the outer surface of the cannula sleeve 202.

Optical penetrating adapter 100 may comprise a polymeric material and befabricated via known injection molding techniques. Alternatively,optical penetrating adapter 100 may comprise an optical glass. Theoptical penetrating adapter 100 may be monolithically formed or theproximal mounting section 102 may be a separate component assembled withthe distal penetrating section 104.

Distal penetrating section 104 defines transparent window 108 whichpermits visualization along the adapter axis “x” of cannula sleeve 202and, desirably, locations offset relative to the adapter axis “x”. Theterm “transparent” is to be interpreted as having the ability to permitthe passage of light with or without clear imaging capabilities.Moreover, the transparent material includes any transparent ortranslucent material or any material which is not opaque to visiblelight or other radiation utilized for imaging. It is also to beappreciated that only a portion of transparent window 108 needs to betransparent. Furthermore, a portion of optical penetrating adapter 100or the entire adapter may be translucent or transparent.

Transparent window 108 is generally tapered in configuration, e.g.,bulbous or conically-shaped, to facilitate passage through body tissue.In one preferred embodiment, transparent window 108 includes singlearcuate surface 110 defining arcuate penetrating end face 112.Penetrating end face 112 is generally arranged at an oblique angle “b”relative to the adapter axis “x” and extends to remote penetrating tipor apex 114. Angle “b” is measured at a central plane passing throughaxis “x” and may range from about 30° to about 60° and is preferablyabout 45° relative to adapter axis “x”. Penetrating tip 114 may bepointed; however, in the preferred embodiment, penetrating tip 114 isrounded or arcuate as shown. The rounded configuration of penetratingtip 114 prevents undesired piercing or cutting of tissue during entry ofpenetrating end face 112. Penetrating tip 114 is radially displacedrelative to adapter axis “x”. Penetrating tip 114 presents a reducedprofile to facilitate initial insertion within a narrow incision oropening in tissue. The gradual taper of arcuate surface 110 extendsoutwardly in directions lateral to axis “x” as well as the verticaldirection and provides gradual separation, dissection, and/or retractionof tissue during entry of optical penetrating adapter 100 within thetissue.

In an alternative embodiment, as shown in FIGS. 2D and 2E, transparentwindow 108′ may include a pair of intersecting surfaces 116 in lieu ofsingle arcuate surface 110. Intersecting surfaces 116 are substantiallyplanar but may be concave or convex in configuration. Intersectingsurfaces 116 may define an end face edge 118 along the line ofintersection of the faces 116. Edge 118 is preferably centered withrespect to the longitudinal axis. Thus, during visualization, edge 118may be seen as a thin line through the viewing field, so as not tosubstantially obstruct viewing of the body tissue through intersectingsurfaces 116. In this embodiment, penetrating tip 120 is pointed whichmay facilitate piercing or cutting of tissue. Similarly, end face edge118 may be sharpened to incise the tissue during entry of the adapter.Alternatively, the edges of the transparent window 108′ my be curved andmore blunt.

FIGS. 3A-3D illustrate an alternate embodiment of the opticalpenetrating adapter of the present disclosure. Optical penetratingadapter 300 includes penetrating section 302 which is generallypyramidal in configuration, i.e., having at least three primary surfaces304 arranged to define the tapered optical window shown. Adjacentprimary surfaces 304 are connected by auxiliary surfaces 306. Primaryand auxiliary surfaces 304, 306 extend to apex or penetrating end face308 which is preferably rounded, arcuate or blunted. Apex 308 is ingeneral alignment with the adapter axis “x” of optical penetratingadapter 300. Primary surfaces 304 may be concave as shown in FIG. 3D ormay be substantially planar primary surfaces 304′ as shown in FIG. 3E.Auxiliary surfaces 306 may be generally convex (FIG. 3D) or generallyplanar 306′ in configuration as shown in the embodiment of FIG. 3E. Asappreciated, in the embodiment of FIG. 3D, penetrating section 302 isdevoid of any sharp edges, due in part to the presence of convexauxiliary surfaces 306 and rounded penetrating end face 308. Thispenetrating section 302 of FIG. 3D may be desirable in procedures wherepenetration of the tissue is to be performed without piercing or cuttingtissue, but, rather via retracting, separating or dissecting tissue. Inthe embodiment of FIG. 3E, penetrating section 302′ may incorporateedges 310 at the junctures of primary surfaces 304′ with auxiliarysurfaces 306″. Edges 310 may be sharpened to facilitate piercing orcutting of tissue.

FIGS. 4A-4C illustrate another alternate embodiment of the opticalpenetrating adapter of the present disclosure. Optical penetratingadapter 400 includes first and second primary surfaces 402interconnected by secondary surface 404. Secondary surface 404 definesend face 406. End face 406 is arranged at an oblique angle “c” relativeto adapted axis “x” and extends to penetrating tip 408. Penetrating tip408 is radially displaced relative to the axis “x” of adapter 100 and isrounded as shown. Secondary surface 404 is preferably bulbous orgenerally convex and is continuous along the general axis of adapter 100thereby permitting visualization along the axis during penetration oftissue (i.e., secondary surface 404 is devoid of any edges adjacent theaxis “x” of adapter 100). Accordingly, with this embodiment of opticalpenetrating adapter 400, visualization along the axis “x” is notimpeded. Penetrating tip 408 provides a reduced profile to facilitateinitial insertion of optical penetrating adapter 400 within a narrowincision.

FIGS. 5A-5E illustrate another alternate embodiment of the opticalpenetrating adapter of the present disclosure. Optical penetratingadapter 500 includes penetrating section 502 defining a transparentwindow consisting of multiple surfaces. Specifically, penetratingsection 502 includes arcuate nose 504 which defines apex or penetratingend face 506. Arcuate nose 504 is semicircular in a first extent asviewed in the side plan view of FIG. 5C and is generally rectangular inma second extent defining a narrow cross-section as viewed in the axialview of FIG. 5E. Extending contiguously from arcuate nose 504 is a pairof opposed first surfaces 508 which are obliquely arranged relative toadapter axis “x” and diverge outwardly toward the proximal end of theadapter 500. Extending contiguously from first surfaces 508 is a pair ofsecond surfaces 510 which also diverge outwardly from the adapter axis“x”, preferably, at a greater angle of divergence than first surfaces508. First surfaces 508 intersect arcuate nose 504 along lines ofintersection 512. Second surfaces 510 intersect first surfaces 508 alonglines of intersection 514. Lines of intersection 512, 514 are eachobliquely arranged relative to longitudinal axis “x” at an angle “m”.Angle “m” preferably ranges from about 30° to about 60°, morepreferably, about 45°. First and second surfaces 508, 510 may be planar,concave, or convex in configuration. Penetrating section 502 of opticalpenetrating adapter 500 presents a reduced profile which facilitatespassage of the penetrating section 502 through tissue. In particular,the narrow configuration of arcuate nose 504 permits relatively easyinitial entry into, and manipulation within, the narrow incision orwound site. Primary and secondary surfaces 508, 510 provide gradualretraction or dissection of the tissue defining the incision or openingduring passage of the optical penetrating adapter 500 through tissue.Moreover, the arrangement of primary and secondary surfaces 508, 510 andthe oblique characteristic of the lines of intersection 512, 514 definea streamlined profile which substantially minimizes tissue resistance.

FIGS. 6A-6E illustrates another embodiment of the present disclosure.Optical penetrating adapter 600 is similar to the optical penetratingadapter 500 of FIGS. 5A-5E. However, with this embodiment arcuate nose602 is generally tapered in a first extent in the side plan view of FIG.6C, defining a frusto-conical configuration having rounded arcuate apexor end face 604. The frusto-conical configuration defines a narrow nose602 relative to the corresponding nose 504 of optical penetratingadapter 500. This narrow nose 602 further facilitates initial entry andmanipulation within a relatively small incision or opening in tissue. Inaddition, the gradual taper of nose 602 provides for a relativelygradual retraction or separation of tissue.

FIGS. 7A-7E illustrate another alternate embodiment of the opticalpenetrating adapter of the present disclosure. Optical penetratingadapter 700 includes an optical window having arcuate or bulbouspenetrating surface 702 defining rounded apex or penetrating end face704. Penetrating end face 704 is arranged at an oblique angle relativeto the adapter axis “x” to define an extreme tip 704′. First surfaces706 contiguously extend from penetrating surface 704 and are preferablysubstantially parallel to adapter axis “x”. Second surfaces 708intersect first surfaces 706 along lines of intersection 710 and divergeoutwardly in the proximal direction at a predetermined angle relative toadapter axis “x’. Third surfaces 712 intersect second surfaces 708 alonglines of intersection 714 and extend outwardly relative to axis “x” at apredetermined angle greater than the angle of divergence of secondsurfaces 708. Optical penetrating adapter 700 provides a more narrowprofile relative to the adapters of the prior embodiments. Inparticular, the extreme tip 704′ as provided by the inclination ofpenetrating end face 704 permits insertion in relatively narrow incisionor opening sites. The parallel arrangement of first surfaces 706presents a reduced profile during initial passage of penetrating end 702through tissue. The oblique arrangement of second and third surfaces708, 712 provides for gradual separation of the tissue while the obliquelines of intersection 710, 714 present minimal resistance to the engagedtissue.

The transparent windows in accordance with this disclosure may includean image directing member (not shown) for directing optical images intothe longitudinal passage 206 of the cannula sleeve 202 or back to animage apparatus. The image directing member may be a lens, an opticalprism, an optical mirror, or like image directing medium.

Referring now to FIG. 8, the use of the optical penetrating adaptersduring a laparoscopic surgery will be discussed. The peritoneal cavity“p” is insufflated as is conventional to raise the cavity wall toprovide greater access to tissue and organs therewithin. Thereafter, anyof the aforementioned optical penetrating adapters is mounted to cannulasleeve 202 of the conventional cannula assembly 200. (For referencepurposes, adapter 100 of FIG. 2A will be utilized). An endoscope 300 ispositioned within the cannula assembly 200. One suitable endoscope isdisclosed in commonly assigned U.S. Pat. No. 5,718,664 to Peck et al.,the contents of which are incorporated herein by reference. The internalseal within cannula housing 204 may form a fluid tight seal about theendoscope 300. As appreciated, endoscope 300 is advanced within cannulasleeve 202 until the distal end 302 of the endoscope 300 is adjacenttransparent window 108 of optical penetrating adapter 100. In thisposition, the distal lens element of the endoscope 300 is adjacenttransparent window 108 so as to be capable of viewing the tissue beingentered. Endoscope 300 may be secured relative to the cannula assembly200 utilizing a resilient washer or a cam locking system incorporatedwith the cannula assembly 200 or formed separately therefrom.

The procedure is continued by positioning optical penetrating adapter100 within a previously formed opening or incision “i” in tissue “t” andadvancing the adapter 100 to retract, dissect, or penetrate the tissue.During penetration of the body tissue, the surgeon observes theunderlying tissue through the endoscope 300 to ensure there is noundesired contact with organs, tissue, etc. lying beneath the peritoneallining. In instances where a video system is utilized, the surgeonsimply observes the penetration of body tissue “t” via any known videomonitor. Once the surgeon penetrates the body tissue “t” and positionsthe distal end of cannula sleeve 202 in the desired position within theperitoneal cavity “p” as observed through the endoscope 200, the surgeondiscontinues the application of force. Surgery is then carried outthrough other cannula assemblies which access the peritoneal cavity.This surgery may be monitored with endoscope 300 as visualized throughtransparent window 108.

It will be understood that various modifications can be made to theembodiments of the present invention herein disclosed without departingfrom the spirit and scope thereof. For example, the present disclosurealso contemplates a surgical kit which incorporates at least one, andpreferably, at least two, of the aforedescribed optical penetratingadapters with or without a cannula assembly. Also, various modificationsmay be made in the configuration of the parts. Therefore, the abovedescription should not be construed as limiting the invention but merelyas exemplifications of preferred embodiments thereof. Those skilled inthe art will envision other modifications within the scope and spirit ofthe present invention as defined by the claims appended hereto.

1. An optical penetrating system for permitting visualization, whichcomprises: a surgical portal having at least one seal for maintaininginsufflation pressure in the abdominal cavity; an adapter memberdefining a longitudinal axis and having a proximal end, a distal end,and a transparent window adapted to penetrate tissue, the transparentwindow being adapted to permit visualization therethrough, thetransparent window including an arcuate nose defining an apex, a pair ofopposed first surfaces having a generally planar configuration andextending contiguously from the arcuate nose and arranged at a firstoblique angle relative to the adapter axis, and a pair of opposed secondsurfaces having a generally planar configuration and positionedproximally of the pair of opposed first surfaces and extendingcontiguously therefrom in a proximal direction, wherein the pair ofopposed first surfaces intersect the arcuate nose along a first line ofintersection extending obliquely in relation to the longitudinal axis ofthe adapter member, and the pair of opposed second surfaces intersectthe pair of opposed first surfaces along a second line of intersectionextending obliquely in relation to the longitudinal axis of the adaptermember, the first and second lines of intersection being substantiallyparallel in relation to each other, the pair of opposed second surfacesbeing arranged at a second oblique angle greater than the first obliqueangle relative to the adapter axis; and means for coupling the adaptermember to the surgical portal.
 2. The system according to claim 1wherein the adapter member includes an internal bore adapted to receivethe surgical portal to releasably couple the transparent window to thesurgical portal.
 3. The system according to claim 1 wherein the adaptermember defines an outer wall dimensioned for reception within aninternal lumen of the surgical portal to couple the adapter member tothe surgical portal.
 4. The system according to claim 1 wherein thearcuate nose is generally frusto-conical in shape along a first extentof the adapter member.
 5. The system according to claim 1 including acannula assembly having a cannula sleeve whereby the adapter member ismountable to the cannula sleeve, the cannula assembly and the adaptermember forming a surgical kit.
 6. The system according to claim 1,wherein the pair of opposed first surfaces are diametrically opposed andthe pair of opposed second surfaces are diametrically opposed.
 7. Thesystem according to claim 1, wherein the first and second lines ofintersection each define an angle with the adapter axis substantiallywithin the range of 30° to 60°.
 8. The system according to claim 7,wherein the first and second lines of intersection each define an anglewith the adapter axis substantially equal to 45°.
 9. The systemaccording to claim 1, wherein the generally planar configurations of thepairs of opposed first and second surfaces extend along axessubstantially parallel to the longitudinal axis.
 10. An opticalpenetrating system for permitting visualization, which comprises: asurgical portal having a distal end and at least one seal formaintaining insufflation pressure in the abdominal cavity; and anadapter member configured for connection to the distal end of thesurgical portal, the adapter member defining a longitudinal axis andhaving a proximal end, a distal end, and a transparent window with anose defining an apex adapted to penetrate tissue, the transparentwindow being adapted to permit visualization therethrough, thetransparent window including a pair of opposed first surfaces having agenerally planar configuration and extending contiguously from the nose,and a pair of opposed second surfaces having a generally planarconfiguration and positioned proximally of the pair of opposed firstsurfaces and extending contiguously therefrom, wherein the pair ofopposed first surfaces intersect the nose along a first line ofintersection in relation to the longitudinal axis of the adapter member,and the pair of opposed second surfaces intersect the pair of opposedfirst surfaces along a second line of intersection extending obliquelyin relation to the longitudinal axis of the adapter member, the firstand second lines of intersection being substantially parallel inrelation to each other.
 11. The system according to claim 10, whereinthe pair of opposed first surfaces are arranged at a first oblique anglerelative to the adapter axis, and the pair of opposed second surfacesare arranged at a second oblique angle relative to the adapter axis, thesecond oblique angle being greater than the first oblique angle.
 12. Thesystem according to claim 10, wherein the pair of opposed secondsurfaces extends contiguously from the pair of opposed first surfaces ina proximal direction.
 13. The system according to claim 10, wherein thepair of opposed first surfaces and the pair of opposed second surfaceseach extend radially outward relative to the longitudinal axis of theadapter member.
 14. The system according to claim 10, wherein the pairof opposed first surfaces and the pair of opposed second surfaces eachextend radially outward relative to the longitudinal axis of the adaptermember.
 15. The system according to claim 14, wherein the pair of firstsurfaces are diametrically opposed and the pair of second surfaces arediametrically opposed.
 16. The system according to claim 10, wherein thegenerally planar configurations of the pairs of opposed first and secondsurfaces extend along axes substantially parallel to the longitudinalaxis.
 17. An adapter member configured and dimensioned for use with asurgical portal adapted to permit access to an internal workspace with asurgical instrument, the adapter member defining a longitudinal axis andcomprising: a proximal end, a distal end, and a window with a nose, thenose defining an apex adapted to penetrate tissue and formed from amaterial facilitating the passage of light therethrough to permitvisualization though the adapter, the window including a pair of opposedfirst surfaces having a generally planar configuration and a pair ofopposed second surfaces having a generally planar configuration, thepair of opposed first surfaces extending contiguously from the pair ofopposed second surfaces in a proximal direction, wherein the pair ofopposed first surfaces intersect the nose along a first line ofintersection extending obliquely in relation to the longitudinal axis ofthe adapter member, and the pair of opposed second surfaces intersectthe pair of opposed first surfaces along a second line of intersectionextending obliquely in relation to the longitudinal axis of the adaptermember, the first and second lines of intersection being substantiallyparallel in relation to each other.
 18. The adapter member according toclaim 17 wherein the nose has an arcuate configuration.
 19. The adaptermember according to claim 17, wherein the opposed first surfaces arearranged at a first oblique angle relative to the adapter axis, and thepair of opposed second surfaces are arranged at a second, greateroblique angle relative to the adapter axis.
 20. The adapter memberaccording to claim 17, wherein the pair of opposed first surfaces arediametrically opposed and the pair of opposed second surfaces arediametrically opposed.
 21. The adapter member according to claim 17,wherein the generally planar configurations of the pairs of opposedfirst and second surfaces extend along axes substantially parallel tothe longitudinal axis.